On Aug. 26, 1994, the plague struck Surat, a city in the state of Gujarat in western India, and Government officials declared an international public health emergency. The plague in Surat was mostly pneumonic, though the bubonic form was found in three villages in Maharashtra preceding the pneumonic outbreak in Surat.

Because of rumors that Surat would be quarantined and when that action was delayed one-fourth of Surat residents (400,000 to 600,000 people) fled the city within four days of announcement of the epidemic. By Oct. 18, 1994, a total of 52 plague related deaths were reported and total suspected cases numbered approximately 1000.

After the Surat plague epidemic in 1994, India took several steps to be prepared for such incidents in future. In response to the outbreak, medical school course work has been revised to address plague in greater detail. The National Institute for Communicable Disease’s plague research unit has been modernized to make diagnosis easier. In addition to activating plague control units all over the country, the national government decided to set up a more sophisticated national surveillance system. The recent pneumonic plague outbreak in Himachal Pradesh 2002 was quickly and effectively contained. The government took rapid preventive action and there was better flow of information which prevented the unnecessary panic